Posts for tag: plantar faciitis
Denver Broncos quarterback Peyton Manning may need to keep off his feet for several months in order to heal his torn plantar fascia. It's really too bad. He probably could have avoided this scenario by putting his feet up to begin with and following specific measures to heal his plantar fasciitis. But as the quarterback of his team that was probably never going to happen.
As a Seattle podiatrist, my advice is if you already have an injury or foot condition; don't tempt fate by continuing to play on it. The risk of an injury that will take you out is great.
So who's likely to get a potentially career ending injury like Peytons?
Certain Foot Types
Interestingly Peyton's brother Eli has also suffered from heel pain. Although heel pain per se is not known to run in families, foot types do. It's very likely that both Eli and Peyton have excessive pronation due to faulty foot structure, like a flat foot. A high arched foot can also place you at higher risk for plantar fasciitis.
Tight Calf Muscles
Tight calf muscles or equinus can also contribute to the development of plantar fasciitis. A tight calf muscle limits the ability to move forward at the ankle. When this happens something has to give--that something is the plantar fascia. If you're got tight calf muscles and you overstress that part of your body by running or playing football you're at greater risk for heel pain
Older weekend warriors
Older runners and athletes are more likely to develop plantar fasciitis than their younger counterparts. And if you're just playing on the weekend, that risk goes up even higher. Age was also likely a factor for Peyton. For a football player 39 is old. Although he might have gotten away with heel pain in his 20s, his older body just couldn't bounce back the way it once could.
More information about heel pain and other sports injuries:
So if you're a runner or athlete and have foot pain or heel pain, stop running on it and come and see me.
Call us today at 206-368-7000 for an appointment, often same day. You can also request an appointment online.
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Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.
Heel pain, heel pain, heel pain. On the average we see three to five cases of this a day, times thirty years of practice, equals an epidemic of heel pain. If you’ve been putting up with heel pain, you know how fatiguing it can be. The answer to the question above, is “No, don’t cut your foot off!”, even though some of my patients are ready to do just that. First let me review the major factors responsible for heel pain and plantar fasciitis.
#1 plantar fasciitis most commonly involves an inflammation of the attachment of the plantar fascia (flat ligament) at its origin on the bottom of your heel bone, the calcaneus.
#2 It is often, but not necessarily associated with a foot that is flat or one that pronates excessively (collapses the arch) while walking
#3 It is aggravated by standing on your feet all day, athletic activities, obesity, poor shoes, and what I often call the “X” factor, Equinus=tight Achilles tendon/calf muscle.
Therefore, regardless of whether you have orthotics or not, if you have inflammation then it must be treated. We’ve become a lot more proactive about this and are now using a nice combination of ice, topical analgesic, Biofreeze, and a topical anti-inflammatory compounded by our pharmacy to attack inflammation more successfully. You must reduce the pain to be able to restore more normal walking.
Patients will find themselves walking on their toes to avoid the pain, and this will simply make the pain worse. A new, plantar fascial strap that is removable may also be of great benefit in reducing the pain and inflammation.
If you’re already wearing some type of over the counter arch support, it may be time to have an orthotic fabricated that will truly match your foot type and rebalance the faulty foot mechanics. If you have orthotics, an annual check on them will help determine if they are in need of a tune up or replacement. Non supportive shoes will not allow the orthotic to do its job, and your feet may still pronate excessively. Have them checked by your podiatrist to see if you’re wearing the right shoe for the right activity.
Finally, and possibly most importantly, you must address the “X”factor, tight calves/Achilles tendon. This is best treated by a daily stretching program, use of an Achilles splint, and with chronic cases Dr. Berg will dispense a firm heel lift and prescribe physical therapy.
Very few cases of plantar fasciitis require surgical intervention. If your heels are killing you, have your feet evaluated by your podiatrist, and be sure you’ve exhausted all conservative measures. Once the most significant causes are identified, the problem can usually be rectified fairly easily, and get you back to your daily activities pain free.
Rion A. Berg, DPM
Podiatrist and Board Certified Foot Surgeon
Foot and Ankle Center of Lake City
2611 NE 125th St., #130
Seattle, WA 98125
Dr. Berg is available to speak at your association, civic group, Meet-up group, or medical staff in-services in the North Seattle area. Please call 206.368.7000 or email [email protected] to make arrangements.
Keeping Your Feet Happy In The New Year
No matter what your New Year’s resolutions are, your feet may have suffered through the holiday shopping, and now it’s time to treat them right. Since you can’t just replace them like a set of tires, you may want to consider having them balanced and realigned.
Looking back on the previous year, there are some balance and alignment problems of the feet that could have been avoided if patients had more education about basic foot function.
#1 Heel pain, which most commonly presents with pain in the bottom of the heel, involves the overpulling of the plantar fascia at it’s attachment to the heel bone. The presence of a bone spur with this does not usually mean surgery is necessary. At least 75% of the time, I have also found that the calf muscle/Achilles tendon which attaches in the back of the heel, is also tight. This I call the “X” factor, and it must be treated as well.
The first steps to treating plantar fasciitis therefore, are to support the foot better to decrease the pull of the fascia, and to stretch the Achilles/calf muscle. The first step in increasing support, is to replace the insoles that came with the shoe with a good over the counter full length support. Superfeet and Spenco are available in local stores. Powerstep supports are available through our office. You may also want to temporarily use a heel lift under the support, which will immediately decrease the Achilles overpull. Have your athletic shoes or walking shoes checked for stability. Ice regularly, and avoid going barefoot at home.
When talking about shoes, you have to think about what you’re expecting the shoe to do for you. The foot has to absorb your weight at heel strike, it has to absorb the rotation of your legs as you move over the foot, and it has to convert from a flexible shock absorber (heel strike) into a rigid lever as you propel over the ball of your foot. Clearly, if you sit at work and wear dress shoes, your feet have different demands than when you are exercising in athletic shoes.That said, a shoe needs good stability in the heel, good shock absorption in the midsole, and finally it should bend at the ball, not in the middle, and not twist easily from side to side.
I can’t tell you how many times I’ve had someone come in who stands on their feet all day in construction, but chooses to wear an open backed pair of shoes because they are soft and slip on easily. This is not a work shoe or a walking shoe! There is no doubt that laced shoes are more supportive than slip on shoes. And for women, a low heeled dress shoe is often more supportive than flats.
Finally, I ended 2011 with a patient who complained of pain in the end of her great toe. She had a successful surgery to correct an ingrown toenail some time ago. After examination, I had her put on her shoes, and lo and behold the shoes were too short. Our feet get longer as we age. It is better to buy shoes where someone who is trained to fit shoes, actually measures your feet and then checks the fit of the shoe. In our office, that is Leandra Taylor, our shoe fitting specialist, (pictured at right).
In summary, balance out your foot mechanics with good stretching, good shoes, and good support. If your problems persist despite following some of these basic rules, start the new year right and have your feet evaluated by your podiatrist.
Rion A Berg, DPM
Podiatrist and Board Certified Foot Surgeon
The Foot and Ankle Center of Lake City is located in Northeast Seattle, serving the neighborhoods of Lake City, Mapleleaf, Wedgewood, Sandpoint, Kenmore, Bothell, Northgate and Shoreline.